Medical history (history of illness) represents an important component in the diagnosis of benign prostatic hyperplasia (BPH; benign prostatic enlargement).
Family history
Social history
Current anamnesis/systemic anamnesis (somatic and psychological complaints).
- Do you have an urge to urinate frequently without increased urination?
- Do you have involuntary leakage of urine under urge to urinate?
- Is the duration of urination prolonged?
- Have you noticed a weakening of the urinary stream?
- Do you have to urinate more frequently at night?
- Do you have an urge to urinate that cannot be suppressed, with pain?
Vegetative anamnesis incl. nutritional anamnesis.
Self anamnesis incl. medication anamnesis
- Pre-existing conditions (diseases of the genitourinary system).
- Operations
- Allergies
- Medication history
The initial diagnosis includes first of all the medical history
This should include subjective complaints using the IPSS (International Prostate Symptom Score). This rapid test includes seven questions about any symptoms experienced during urination.IPSS score – the questions refer to the last four weeks.
| Never | Less often than one in five times | Less frequently than in half of the cases | About half of the time | In more than half of all cases | Almost always | |
| How often did you feel that your bladder was not completely empty after urinating? | 0 | 1 | 2 | 3 | 4 | 5 |
| How many times did you have to urinate a second time within 2 hours? | 0 | 1 | 2 | 3 | 4 | 5 |
| How often have you had to stop and start again several times when urinating (urinary stuttering)? | 0 | 1 | 2 | 3 | 4 | 5 |
| How often have you had difficulty delaying urination? | 0 | 1 | 2 | 3 | 4 | 5 |
| How often did you have a weak stream when you urinated? | 0 | 1 | 2 | 3 | 4 | 5 |
| How often did you have to push or strain to start urinating? | 0 | 1 | 2 | 3 | 4 | 5 |
| On average, how many times did you get up at night to urinate? | Never 0 | Once 1 | Twice 2 | Three times 3 | Four times 4 | Five times or more 5 |
Rating IPSS
- 0-7 points mild symptomatology
- 7-19 points moderate symptomatology
- 20-35 points severe symptomatology.
An indication for therapy is generally seen with an IPSS score above 7.
Of particular importance is also the digital rectal examination (DRU), a palpation examination in which the prostate is palpated from the rectum.Assessed are.
- Size – usually the size of a chestnut
- Consistency – usually plump elastic
- Surface – usually smooth
- Any local changes – e.g. indurations (hardening).